Abstract
Objective
Recent evidence suggest that long inter-pregnancy interval (IPI; defined as a time interval between a live birth and estimated time of conception of a subsequent pregnancy of over 60 months) poses a risk for adverse short-term perinatal outcome. We aimed to study the effect of short (< 6 months) and long IPIs on long-term cardiovascular health of the offspring.
Study Design
A population-based cohort study was performed in which all singleton live births in parturients with at least one previous birth were included. Deliveries occurred between the years 1991-2014 at a single regional tertiary medical center. Hospitalizations of the offspring up to the age of 18 years involving cardiovascular diseases were evaluated according to a predefined set of related ICD codes. Outcomes were evaluated according to IPI length. Intermediate interval, between 6 (short) and 60 (long) months was considered the reference. Kaplan-Meier survival curves were used to compare the cumulative morbidity incidence between the groups, and Cox hazards regression models, to control for confounders.
Results
During the study period 144,397 deliveries met the inclusion criteria. Of them, 13.1% (n=18,947) occurred in women with short IPIs, 79.0% (n=114,012) in women with intermediate IPIs, and 7.9% (n=11,438) in women with long IPIs. Total hospitalizations of the offspring, involving cardiovascular morbidity, were comparable between the groups (Table). The Kaplan-Meier survival curves demonstrated similar cumulative incidences of cardiovascular morbidity in all groups (Figure). In the Cox regression models, controlled for maternal age, diabetes mellitus and hypertensive disorders of pregnancy, prematurity, and birthweight, short and long IPI did not appear as independent risk factors for later pediatric cardiovascular related hospitalizations in the offspring (adjusted HR 0.96, 95%CI 0.79-1.20; and adjusted HR 1.06, 95%CI 0.82-1.40, respectively).
Conclusion
Extreme IPIs do not appear to impact on long-term cardiovascular health of the offspring.
Recent evidence suggest that long inter-pregnancy interval (IPI; defined as a time interval between a live birth and estimated time of conception of a subsequent pregnancy of over 60 months) poses a risk for adverse short-term perinatal outcome. We aimed to study the effect of short (< 6 months) and long IPIs on long-term cardiovascular health of the offspring.
Study Design
A population-based cohort study was performed in which all singleton live births in parturients with at least one previous birth were included. Deliveries occurred between the years 1991-2014 at a single regional tertiary medical center. Hospitalizations of the offspring up to the age of 18 years involving cardiovascular diseases were evaluated according to a predefined set of related ICD codes. Outcomes were evaluated according to IPI length. Intermediate interval, between 6 (short) and 60 (long) months was considered the reference. Kaplan-Meier survival curves were used to compare the cumulative morbidity incidence between the groups, and Cox hazards regression models, to control for confounders.
Results
During the study period 144,397 deliveries met the inclusion criteria. Of them, 13.1% (n=18,947) occurred in women with short IPIs, 79.0% (n=114,012) in women with intermediate IPIs, and 7.9% (n=11,438) in women with long IPIs. Total hospitalizations of the offspring, involving cardiovascular morbidity, were comparable between the groups (Table). The Kaplan-Meier survival curves demonstrated similar cumulative incidences of cardiovascular morbidity in all groups (Figure). In the Cox regression models, controlled for maternal age, diabetes mellitus and hypertensive disorders of pregnancy, prematurity, and birthweight, short and long IPI did not appear as independent risk factors for later pediatric cardiovascular related hospitalizations in the offspring (adjusted HR 0.96, 95%CI 0.79-1.20; and adjusted HR 1.06, 95%CI 0.82-1.40, respectively).
Conclusion
Extreme IPIs do not appear to impact on long-term cardiovascular health of the offspring.
| Original language | English |
|---|---|
| Pages (from-to) | S123-S124 |
| Journal | American Journal of Obstetrics and Gynecology |
| Volume | 222 |
| Issue number | 1, Supplement |
| DOIs | |
| State | Published - Jan 2020 |